Article by the experts: Esra Yildirim Bay et al.
The aging process profoundly affects our skin, a multifunctional organ essential to our health and well-being. As the years go by, our skin undergoes significant changes in its structure and functions, both internally and externally. Intrinsic aging, determined by biological and genetic factors, is coupled with extrinsic aging, which is influenced by environment and lifestyle. This combination leads to loss of skin elasticity, firmness and vitality as collagen, elastin and other key components decline. In addition, several molecular and hormonal mechanisms have been identified that contribute to this process. We will explore the underlying causes of skin aging and examine basic strategies to promote healthy skin aging and protect against the effects of time and the environment.
As we age, the skin undergoes a series of both qualitative and quantitative changes in all layers of the epidermis. Reductions in the proportion of lipids in the stratum corneum and ceramide levels are observed, contributing to a decrease in skin barrier function and increased susceptibility to irritation. In addition, aging skin is more prone to irritation due to reduced filaggrin and skin barrier.
Over time, epidermal turnover decreases and the shape of keratinocytes shortens, especially in the stratum spinosum, leading to an obvious atrophy in this layer. The cells of the basal layer become more uniform and the amount of natural moisturizing factors (NMF) in the skin is reduced, resulting in less hydrated skin. Flattening of the dermoepidermal junction and elimination of the dermal papilla affect proper communication and nutrient transfer between the epidermis and dermis, compromising the health and vitality of aging skin.
Although the effect of stress on skin aging is not yet fully understood, it has been observed that chronic stress can affect immunity, wound healing and increase inflammation.
Regular exercise can facilitate the supply of oxygen and nutrients to the skin, which promotes the formation of new cells and increases blood flow. In addition, a balanced diet rich in antioxidants can reduce the signs of skin aging, such as wrinkles and photoaging.
In the last decade, the focus has been on studies that seek to prevent or delay skin aging at the cellular and molecular level, while less invasive cosmetic procedures have gained popularity in skin care. Anti-aging treatment strategies can be divided into primary preventive approaches, before signs of aging appear, and secondary approaches, which are addressed once signs of aging are evident.
Medical professionals commonly encounter the challenges of skin aging and associated clinical conditions in their daily practice. Because skin aging is a complex and progressive process, it is crucial to approach it with well-defined treatment strategies. Dividing these strategies into primary and secondary preventive approaches can provide clear guidance for clinicians when designing personalized treatment plans.
It is critical that patients follow a consistent and precise skin care regimen that includes sunscreen with a minimum SPF of 30 (preferably tinted), gentle cleansers, moisturizers, nightly topical retinoids and both oral and topical antioxidants as part of their daily routine. In addition, products such as hydroxy acids, growth factors, peptides and stem cells may be considered depending on the specific needs of each patient's skin.
Educating patients about the importance of a healthy lifestyle and providing them with detailed information about available treatment options can significantly increase their adherence to their skin care regimen and improve long-term results. Ultimately, the combination of proper skin care and healthy lifestyle habits can help maintain skin health and vitality over time.
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